Rare cystic liver lesions: A diagnostic and managing challenge

Abstract

Cystic formations within the liver are a frequent finding among populations. Besides the common cystic lesions, like simple liver cysts, rare cystic liver lesions like cystadenocarcinoma should also be considered in the differential diagnosis. Thorough knowledge of each entity’s nature and course are key elements to successful treatment. Detailed search in PubMed, Cochrane Database, and international published literature regarding rare cystic liver lesions was carried out. In our research are included not only primary rare lesions like cystadenoma, hydatid cyst, and polycystic liver disease, but also secondary ones like metastasis from gastrointestinal stromal tumors lesions. Up-to date knowledge regarding diagnosis and management of rare cystic liver lesions is provided. A diagnostic and therapeutic algorithm is also proposed. The need for a multidisciplinary approach by a team including radiologists and surgeons familiar with liver cystic entities, diagnostic tools, and treatment modalities is stressed. Patients with cystic liver lesions must be carefully evaluated by a multidisciplinary team, in order to receive the most appropriate treatment, since many cystic liver lesions have a malignant potential and evolution.

Keywords: Liver cyst; Cystic tumor; Hepatic lesion; Gastrointestinal stromal tumors; Metastases; Cystadenoma; Cystadenocarcinoma; Hydatid cyst; Polycystic liver disease; Caroli; Echinococcus

Core tip: This paper reviews diagnosis differential diagnosis and management of rare cystic liver lesions which should be considered when a cystic hepatic lesion is identified. A diagnostic and therapeutic algorithm is provided. Patients with cystic liver lesions must be carefully evaluated by a multidisciplinary team, in order to receive the most appropriate treatment, since many cystic liver lesions have a malignant potential and evolution.